Clint Murphy  00:00

Good morning, Jade. Before we dive into your book this morning, can we start with giving a brief introduction to the audience on who you are, if they don’t know yet? Sure.

Jade Wu  00:12

I’m a Hi, I’m Dr. Jade Woo. I am asleep psychologist. So that’s probably a job title that most people haven’t heard of. It just means that I’m a clinical psychologist. And I am trained, especially in the science and art of helping people sleep better.

Clint Murphy  00:29

And so we are discussing your book, hello, sleep. The science and art of overcoming insomnia without medications, which I love, where I’d love to start with you is with a statement you make and just let you color it in for us, which is healthy sleep comes from having a good relationship with sleep. Can you share more on that one? Sure,

Jade Wu  00:54

yes. So the way I like to think about it is, you know, what does a bad relationship with sleep look like that might be the easier place to start. So for example, I have patients who maybe have neglected sleep for many years, and you know, they’re not really in touch with sleep, they’re not a very good friend to sleep, they don’t prioritize sleep, they don’t care about sleep very much, they haven’t really invested much time or energy into sleeping better or helping, you know, sleep flourish. And so that’s one end of the spectrum for not having a good relationship. On the other end of the spectrum is folks who are maybe too overbearing in their relationship with sleep. So they are trying too hard, they are investing, you know, way too much energy and being too rigid about their expectations and saying, you knowmy way or the highway. And that can also be bad for your relationship with sleep. because sleep is not the type of thing that responds well to bullying, either. So with both ends of the spectrum, you know, we are in sort of a, you know, we’re in a strange relationship with sleep. And when that happens, sleep health simply can’t be very good, whether you neglect it, whether you’re overbearing with it, and really the best thing to do is to treat sleep as you would a friend, you know, pay attention to them, spend time with them, prioritize, you know, investing in that relationship, but not do in a way that’s too overbearing or rigid. So that’s what I mean by having good relationship. Because, okay, here’s one more thing I’ll say, is, you know, if you live to be 100, you will have spent something like 33 years sleeping, or at least trying to sleep. So if you’re spending that much time with somebody in a room together, what kind of relationship do you want to have with them, right, so that can be our guiding principle. In

Clint Murphy  02:42

when you look at those two ends of the spectrum, we have someone who just doesn’t pay attention to it, and we have someone who’s really overbearing on it, which one tends to have a worse impact on that sleep relationship, and therefore the quality of their sleep

Jade Wu  02:57

that I think really depends on the person. So you know, when you don’t pay enough attention to it, when you don’t prioritize it, then you end up with someone who might just not get enough sleep. So that’s one type of sleep problem is just not getting enough. And we know from the research that if someone is chronically sleep deficient, then they’re more likely to have cardiometabolic. You know, disorders like heart disease, diabetes, they’re more likely to have cognitive impairments or, you know, cognitive decline later in life, and just in general, not function as well and not be, you know, as healthy as they can be. On the other hand, if someone is more overbearing with sleep, their actual health deficits might not be as severe. So they’re not as much at risk for heart disease, for example, or dementia later on. But they are living with a lot of frustration and a lot of misery often, because they’re constantly worrying about sleep, they’re working on sleep, like it’s an engineering problem, day to day, I’ve had patients come in with like reams of paper or like spreadsheets upon spreadsheets of data that collected you know, what their sleep trackers and on their own, and they just pour so much of their mental energy into this thing that should be easy and natural. So I think both are not so great. One is more objectively bad for your health. The other is for your physical health, I guess, and the other is more objectively bad for your mental health.

Clint Murphy  04:25

In How do you feel about you mentioned the sleep trackers, what are your thoughts with sleep trackers? Are they overdone? Are they helping us? Are they causing more frustration and concern than they should on this sleep journey?

Jade Wu  04:41

Yeah, I think it could be a double edged sword. So on one hand, I’m really excited about the improvements in our sleep tracking technology. Now we can learn about people sleep, in the comfort of their homes in their natural environments, which is a really big boon for sleep science. And also for a lot of people that I’ve worked with I think having sleep tracker can be really helpful. Some people don’t really believe it till they see it, right. They’re like, oh, shoot, I really don’t get enough sleep or I, you know, do sleep worse when I drink a lot of alcohol. And sometimes it just takes a little bit of tracking to really come to those realizations. And you can have a real come to Jesus moment, you know, and that’s what a lot of people need. And then for other people, it can kind of backfire. Because as great as a tool, a sleep tracker can be it only measures sleep, it doesn’t give you any actionable targets necessarily for how to improve your sleep. So it can be extra frustrating. It’s like just because you have a bathroom scale and measure your weight doesn’t mean you’re going to lose weight, or you know, gets your ideal weight, or whatever that may be. In the same sense. A sleep tracker can tell you more information, but doesn’t necessarily tell you how to improve things. And sometimes more information can be too much information and can make us frustrated, anxious. Not to mention that sometimes sleep trackers are not accurate. Yeah, so there are some downsides. So

Clint Murphy  06:05

let’s talk a little bit about some science and some myth, breakdowns, Jade. And what I’d love to look at with you is this idea of sleep architecture, which sounded very interesting as a concept. And you pointed out that it doesn’t follow a lather rinse repeat pattern, because sleep cycles are not that neat. And you talk about how an interesting fact that our brain will automatically adjust how much deep sleep versus REM sleep versus light sleep we get. And in what sequence based on what our current needs are, which seems totally different than you know, that chart we all get when we’re kids that oh, you go into this stage, then this stage now this stage, and you repeat.

Jade Wu  06:59

Yes. Yes, exactly. I mean, those charts are very useful for looking at sort of a prototypical like, you know, this was what sleep generally looks like when you’re a healthy middle aged male, let’s say, right, but it’s kind of like those anatomy diagrams, where you see like an outline of a person. And you see, like, all the bones, and, you know, muscles and stuff inside. That’s a prototypical person. That’s not what everybody looks like, right? It’s just the same thing with our sleep, our sleep is very dynamic. It’s not a one size fits all is not a lather, rinse, repeat my say in the book, that, you know, saying that we cycle through sleep stages is like saying the Rolling Stone cycle through chords, it’s just like not does not capture the beauty and the mystery and the complexity of it. And you’re absolutely right, we automatically adjust. You know, by we, I mean, our brains without any direction from us automatically adjust the proportions of different stages of sleep, and the sequence and the shape that the night takes. So for example, if you are quite sleep deprived, like you’ve just done an ultra marathon, and you’ve been up for 24 hours plus, and your body just needs to recover, you’re probably going to dip into deep sleep a lot sooner than usual, usually is like 60 ish minutes in, maybe like 45 minutes, and you get a little bit of deep sleep. When you’re really sleep deprived, you might go right into deep sleep almost directly. Another example is when you’re pregnant. And when you’re no sorry, that’s a bad example, because pregnancy has lots of hormones that mess up a lot of things, but in postpartum for, for a new mom who is sleep deprived, and let’s say she’s nursing, so she’s lactating, too, she’s not only sleep deprived, she’s growing food for another human being, she will actually have a greater percentage of slow wave sleep, which is deep sleep, whereas someone who’s been REM sleep deprived might be more likely to go more quickly into REM sleep. So it’s just kind of like what are you missing in the moment. And then there’s also a hierarchy of, you know, if you’re generally sleep deprived, your brain wants to catch up on deep sleep first, and then REM sleep and then everything else. Because in REM sleep, that’s where we you know, clear toxins from the brain and release growth hormones and boost our immune system. Those are like the life saving types of important functions. So the brain has to prioritize that. And then everything else gets prioritized according to what, what else is missing

Clint Murphy  09:32

in So you talked a bit about there about how our brains adjusting for us based on what our needs are in the moment, which is a bit counter to the statement we always get, which is you know, more is better and you should sleep for at least eight hours. And I love that you highlight that that number is not the same for everybody. If I look at myself as an example, I typically found that six and a half is a great number for me and Every once in a while I need a longer sleep, like a full deep recharge. But if I go eight hours every night, I almost feel too foggy too much sleep as soon as I cross a certain number. So what is this idea that the optimal number for sleep may be different for all of us, and the concept that how our timing of that sleep also may be different for each and every one of us?

Jade Wu  10:32

Yes, our timing and the amount of sleep we need is different, not only between you and I, but also within ourselves across time. So the amount of sleep that you need today may be different from 10 years ago, and may be different from 10 years from now. And there’s a good reason for this diversity, because, you know, just like we are diverse in our height, for example, you know, as a species that allow some of us to reach the higher fruits and some of us to be able to fit through smaller holes, it’s a good thing for a species to be diverse, right. So when humans sleep at somewhat different times, and for different amounts of time, then, you know, in a tribe of, let’s say, early humans on the Savannah, let’s say, there’s 100 of us, and all of us have slightly different sleep habits, then at least somebody is watching, keeping watch late at night, and somebody is up early enough to string the bows for the hunt later, right. So we that diversity allows our species to survive well. So that’s why we evolved that way. And also, if you look at what our bodies are doing in the day, LeBron James and I are not going to need the same amount of water to survive, and not the same amount of sleep. I mean, he famously sleeps 12 hours a day, because while he’s working out, like at a very high capacity all the time. I don’t need that I’m pretty much a couch potato, and I’m a lot smaller than him. So our biological needs differ based on our genetics based on our lifestyle, and based on what we are currently doing in our lives. So if you’re training for a marathon, if you’re pregnant, if you’re learning French, you know, all of those things will affect what your brain needs to do at night. So one of the biggest things, the best things you can do for your sleep health, is to go with the flow and allow for change.

Clint Murphy  12:16

So a lot of physical stress and training tends to lead to Hey, you probably should get more sleep. What about mental stress and training? So if you have a high demanding job, or you’re constantly thinking all the time, and you’re just come home? And mentally you’re just exhausted? Should you in that situation also probably be sleeping more instead of catching that extra hour of Netflix? That’s

Jade Wu  12:42

a great question. And that’s actually a tricky one to answer. Because, on the one hand, yes, we do need to heal, you know, the burden that mental stressors are putting on our bodies, just like we need to heal from physical stressors on our bodies. On the other hand, when you’re mentally stressed, you’re also more prone to having sleep problems. So you might be in a weird catch 22 situation where the more stressed out you are with your job, the harder it is to sleep well. And the less you sleep well, the less you’re able to cope with that stress. And so yes, we definitely want to prioritize good sleep in these situations. But also, I think one thing we tend to underestimate is how much we need rest. So rest is not sleep, it’s being awake, but doing something to recharge. So that might be hanging out with friends, or for introverts, it might be taking time alone, it might be you know, catching up on a hobby, doing something creative, doing something that’s meaningful or fulfilling or being out in nature. So there are lots of different ways to rest, which is really how you recharge from these mental stressors. Because a lot of the time a mental stressor is stressful, because you don’t have time to do the things that really fill your cup. So in addition to or maybe even instead of really worrying about sleep in these situations, I would really encourage people to look for daytime rest opportunities in one of the important

Clint Murphy  14:12

things that you said about daytime rest that I really want you to reinforce for people so they understand it is that true rest is rejuvenating for your body and mind. It’s not goal oriented. And often, what you have to show for it at the end isn’t quantifiable. And when you talked about that some of the things for example, like what about going for long walks, meditation, journaling. How did these help us get what we want without having that? Hey, like put it in the tracker. We need to hack our way to good sleep.

Jade Wu  14:51

Yes, that’s such a great point. So yeah, a lot of true rest is really hard to quantify because when you are truly resting, you’re not goal oriented, necessarily. I mean, I like to do crafts and stuff. So at the end, you do have technically a craft to show for it. But I didn’t do it in order to sell that craft or to use it for like a life saving, you know, purpose, I did it just because I enjoy it. And it allows me to be creative to work with my hands to smell and see and hear the sounds, you know, that’s what it really boils down to, is really being in the moment in your body. So whatever that means to you, whatever is enjoyable for you, that allows you to be truly present. That’s the thing that really rejuvenates you. So walking is awesome. You know, being with friends can be really great crafts, you know, music, playing it listening to it, reading, journaling, these are great things to do, because, you know, have you ever noticed that when you get into one of these things, you go into kind of a flow state, you don’t really count time, you don’t really count beans, you know, how much of this metric of achieved or you know, it’s not about that you really just are in the moment. And that’s what we’re missing a lot of in our modern life, I think. So

Clint Murphy  16:11

let’s talk about some of what sleep is. And some of the things we want to be thinking about let’s shift let’s talk about insomnia, the problem. So for those listeners who may not have it, for those who do they really want to explore it. What is an insomnia in? How does it progress through what you call the three P’s?

Jade Wu  16:31

Yes, thank you for asking about the three P’s. I love the three P’s. So insomnia is a chronic sleep condition where so chronic just means long term, it’s not like a blip on the radar, or stressful weekend, whatever, it’s at least a month or three months, depending on which you know, diagnostic criteria, you’ll look at, have trouble falling asleep, or staying asleep. So often people will say, you know, I’m so tired, but I just can’t get to sleep, or I wake up a lot during the night and I’m just staring at the ceiling, I’m tossing and turning, can’t get back to sleep, or some people just feel like really unrested even when they technically have slept, it’s just not refreshing. So that’s insomnia. And it tends to progress from, you know, just having a risk to having short term insomnia to having long term Sami because everybody has poor sleep sometimes. But how come some people develop a problem chronically. So that’s the story of the three P’s. The first P is predisposing factors. These are like fire wood that you’ve gathered, but you don’t have a fire yet. So you may never have a fire, but you’re closer to having one. So these are the risk factors for insomnia. So that could just be you know, having a chronic pain condition, for example, or having trauma history, or just being a light sleeper, you know, and some other medical conditions and life circumstances that may make a person more prone to insomnia. And then the second P is precipitating factors. So that’s the spark that lights that flame in the first place. So this might be for some people starting a new job, or losing a job, getting married, getting divorced, you know, a really stressful bout in school or at work. So these things can really throw your sleep off track. Now the good news about the first two pieces that they don’t do mu to long term chronic insomnia, there are lots of people with predisposing factors and precipitating factors who don’t have chronic insomnia, their body adjusts, or they make adaptations in their environment, and they’re fine. But then that’s where the third P comes in, that’s perpetuating factors. These are the logs that we keep adding to the fire that really keep that fire going in the long run. That’s the fuel that we add. And so these are the things that really keep insomnia going. So this is where the having a bad relationship with sleep comes in, you know, if you’re too overbearing, if you’re too rigid about your expectations, if you’re going to bed too early, or staying in bed, when you’re not sleepy, all of these things can lead to your chronic insomnia being maintained in the long run. Okay,

Clint Murphy  19:08

and one of the challenges there, though, is that become self fulfilling? Like I’ve got the precipitating and then I sparked the fire. And now it’s been a week it’s been a month. Oh, I can’t sleep. It’s getting worse. Oh, I gotta go to bed early. I’ve got to, I’ve got to improve my sleep hygiene. And I have to be in bed early in the bed has to be this temperature and I have to eliminate all light and oh, no, I looked at a blue screen before I went to bed. What’s going to happen? At what point like the are the wheels turning Jade and we’re just two judges in we’re making it worse. Yes,

Jade Wu  19:44

absolutely. You gave some really good examples. Those are very common things that you know, my patients say, and lots of, you know, what I call insomnia identity. So you know, after a while someone internalizes this idea fear that, oh, I am an insomniac. This is just who I am. I just don’t sleep well, I’m not good at sleeping. Lots of people tell me they’re not good at sleeping. And then once you have that idea, it’s really a self fulfilling prophecy. Because when you don’t expect to sleep well or you worry about not sleeping well, or you worry about what’s going to happen tomorrow, if you don’t sleep well, that makes you more anxious makes you more frustrated. And guess what sleep doesn’t respond well to anxiety and frustration. Right? So it’s it really it can be a vicious cycle. So part of what I do with patients is to, you know, identify these perpetuating factors, these wheels that are turning to hard and say, and just examine, like, well, is this prediction true? Is this worry warranted? Or is this idea even helpful? And if not, what can we do to change that? And how can we build a better relationship with sleep?

Clint Murphy  20:54

And is this the CBT? For sleep? Yes,

Jade Wu  20:57

it is cognitive behavioral therapy for insomnia? Oh, can

Clint Murphy  21:00

you take people through some of the basics of the CBT, for insomnia because it feels like I know, for me personally, CBT thought auditing in general was one of the greatest concepts that I was introduced to me in my life. And interestingly, I’d never put two and two together. But after I learned to, to some extent, shut off my mind, unless I wanted to use it, I became a better sleeper. Now, I never put I never put those two together. But CBT in general. I think now in hindsight, it helped me become a better sleeper. Now I fall I go to bed, under three minutes, I’m asleep. Now, it’s almost instant, there’s no worldly, worldly mind. So on that thought, I’ll pass it over to you. I

Jade Wu  21:53

love that I think if you can sort of take the ideas of some other form of CBT and apply it to other areas of your life, or have just accidentally have other areas of your life improve. That’s what we aim to do. But yeah, CBT for insomnia, in part is based on that idea. Thought auditing, as you called it, it’s kind of to examine, well, so Okay, let me back up and break it down a little bit. So C is for cognitive, that’s the changing your thoughts. B is for behavioral, that’s for changing your behaviors. So the thoughts piece, you know, we want to look at the thoughts that are making it harder for us to have a good relationship with sleep, thoughts, like, you know, I’m not going to be able to function tomorrow, if I don’t sleep well tonight, or I’m just not a good sleeper, you know, these things will really get in the way of having a good relationship with sleep. So examining gently, non judgmentally. Where do these thoughts come from? Where did I learn this idea? You know, that I’m not a good sleeper? Is it possible that my parents also had insomnia or didn’t learn, you know, good sleep habits. And I grew up thinking that our whole family was just not genetically not good at sleeping. Maybe it’s from that? Maybe my idea of you know, I won’t be able to function tomorrow. If I don’t sleep well, tonight, maybe that comes from popular culture where we say things like, Oh, don’t talk to me, I haven’t had my coffee yet. Or like, I can’t function. I didn’t sleep well, last night. It’s just part of our lexicon, just how we speak. But if you really think about it, you know, if I have a patient who’s had insomnia for 10 years, and they don’t sleep, well, let’s say, you know, half the time, that’s like 150 days a year, 10 years, that’s 1500 nights that they haven’t slept well. While have they had 1500 nights where their day was ruined, where they couldn’t function? If so how are they able to have a family or like hold down a job or just be a human being? So then when we really examine is like, Oh, actually, they function just fine. They’ve just been functioning, kind of kicking and screaming, and like, maybe not allowing that. Yeah, I didn’t sleep, I don’t feel great. But, you know, I did actually function better than I thought I would. So you know, examining these thoughts being a little bit more scientific about it, that’s a cognitive the behavioral is, I think, even more important, that’s where we come up with a schedule for sleep that actually makes sense. So if you are a person who needs six and a half hours of sleep, if you are in bed for 10 hours, then that’s three and a half hours of insomnia, right? That’s just the math, your brain cannot sleep more than you really need. So if you are trying to force it, then you are guaranteeing insomnia. So we do a sleep diary we track sleep over the course of a couple of weeks and we kind of land on this is how much sleep your brain is producing. And which is usually more than what people are estimating and we say okay, if you’re on average sleeping six and a half hours, well let’s be in bed seven hours, give you a little buffer just in case your brain wants to do more and then have people find when they stick to that routine. If they find that, oh, it’s taking me a lot less time to fall asleep, or I’m waking up a lot less, well, then let’s try giving a little more time in bed, see if your brain can fill up just a little bit more time, and then a little bit more, and then a little bit more. And then we hit that sweet spot where, you know, you still don’t have insomnia, you don’t have insomnia anymore, and you aren’t getting enough sleep. So then that’s how you figure out how much sleep you need. So that behavior and you know, other little things like don’t watch the clock and, you know, exercise and get lots of light during the day, things like that. And I teach people mindfulness too, that’s not officially a part of CBT I but I really like to incorporate it because it’s mindfulness is helpful for everything. And sleep is no exception. It’s funny,

Clint Murphy  25:42

because I, when I was finishing my mindfulness teaching course, last year, my mentor got gave me a little bit of a scolding, because there was a cognitive behavioral element to the mindfulness. And what I want to contrast there for the listeners is in that mindfulness, or that meditation side, these thoughts that we’re having, we’re trying to just let them go, just, you know, like, leave falling from a tree, we catch it, put it gently in the stream, let it go on its way. And with that cognitive behavioral therapy side, or the cognitive side, which is coming from stoicism, and as its background, we’re not letting that thought go, we’re challenging it, we’re saying, is that thought real? Or what is a more real thought? In so that side of the tree, when you have insomnia, and we’re trying to just let these thoughts go, it almost feels like that just makes them come back, you know, like, don’t think of the of the white bear. And now all I can think about is the white bear, do you get a little bit of that with your clients in the contrast between the stoicism versus or the cognitive versus the mindfulness?

Jade Wu  26:57

Yeah, that’s such a great question. And that is a little bit of a tug of war, not tug of war. That’s a challenge to be navigated. And I, as a clinician, I don’t necessarily give both to everybody. So depending on the person’s personality, or how sort of how well, mindfulness resonates with them, for example, I may just do mindfulness, we don’t even challenge the thought, Who cares if it’s true, you know, whether you’re going to function well, tomorrow, if you don’t sleep tonight, it is what it is. And you could either battle that thought, and that anxiety, right now, as you’re lying in bed trying to sleep, or you could not, you could just allow that thought to be there, let it float away on its own time. And instead, pay attention to your breathing, or instead pay attention to your little toe and your left foot. Right. So that’s one way to do it another for other people, they really don’t resonate well, with the letting go piece, maybe it’s just takes a little more time to develop, or it’s not their personality. For them, you know, someone who’s like a hardcore lawyer, for example, they for what works for them might be taking their thoughts to court, like, what is the evidence supporting the prosecution’s case, you know, is that fair? Is that you know, enough evidence? So it kind of depends, but yeah, it’s a little tricky mixing the two because then it can get confusing, like, Wait, am I supposed to let this go? Or am I supposed to challenge it in this moment, and I always, I usually default to if you’re on the fence, just get out of your head and into your body. So let that thought go and just focus on your breathing, because that never goes wrong in

 

Clint Murphy  28:39

for people who are saying, they’re hearing us talk about this idea of challenging your thoughts. They may be wondering, well, why am I challenging my thoughts? And is this coming down to the idea that, you know, you know, the science better than me, I always read a different number. But let’s say we have 60,000 thoughts a day, somewhere in the neighborhood of 80% of those thoughts are negative, and they’re just recurring on a on a thought loop. And when we challenge it, we’re taking that record or that song off of the record. So when it’s repeating, we’re not getting that thought, oh, 30 times in the last half hour, I told myself tomorrow will be horrible, because I’m not sleeping right now. And it gets louder and louder. And when we challenge it, we dim it or we maybe even take it off the player for a round or two is that what challenging the thought is trying to do?

Jade Wu  29:33

I think that’s a really nice metaphor that taking the record off the record player, that might that might be what’s happening for a lot of people who are successfully challenging their thoughts. I think, while I’m thinking of one of a good friend of mind, for example, who she’s a very logical, rational person, and, you know, and she’s one where if you present a good argument, she actually will change her belief and you No go with that. So she had insomnia long time ago, and I’ve, you know, helped her. And for her rationally tracking how many times she’s actually been ate and unable to function, for example, has provided enough evidence for her to reverse that thought and genuinely believe, when she tells herself actually, I probably will be able to function because I’ve done it, you know, 10,000 times before. So for her, that’s almost like, reversing the direction of the record, like playing it backwards. And now, but playing it backwards is helpful for her. Whereas I almost think of taking the record off the player is more when you let go of that thought. Like, it’s like, okay, this record exists. And I could play it 30 times, 40 times 50 times, or I could just not play it. You know, I don’t have to argue with the record, I don’t have to judge it or critique it for how good of a song it is. I could just not listen to it. If it’s not serving me well, right now. So yeah, those are maybe the different metaphors I would use. I love

Clint Murphy  31:04

that in something you were just talking about as well, when you were using my example. And you were saying, if you want six and a half hours sleep, maybe we have you in bed for seven hours. And so now we’re starting to talk about this idea of, ideally, I have a sleep log, and I’m logging my sleep. And I’m logging that my time in bed. I think that’s what we might call it my time in bed was seven hours. And my little trackers saying, Well, you slept for six and a half. So I think that gives me maybe an efficiency score. I know there’s a bunch of different numbers that are tracking it. What are we trying to log in? What are some of the improvements we’re trying to make in what we’re logging?

Jade Wu  31:44

Yes. So you hit upon the most important ones there, time in bed. So physically, how long are you in bed as like, that’s your window of opportunity to sleep. Basically, if you’re outside of bed, you’re not sleeping. I mean, sometimes that’s not true. But we want to minimize the falling asleep on the couch while watching TV, too, because that’s taking away from your sleep at night. So assuming all that’s taken care of, then how long you’re in bed is your opportunity for sleep. And then within that window, what percentage of it are you actually sleeping, that’s your sleep efficiency, we want your sleep efficiency to be pretty consistently in the 85 to 95 zone, which means that for the vast majority of your time in bed, you are sleeping, but not 100% of the time, the reason we don’t want your head to hit the pillow and fall asleep immediately. And sleep like a dead log until your alarm goes off in the morning is that means you probably needed a little bit more opportunity to sleep. Like if your brain is so desperate to get to sleep that you have zero awake time in bed that you know, then you may be sleep deprived. So actually, when you were mentioning earlier that you fall asleep within three minutes, I was thinking like oh, am I wonder if he’s maybe like a six and three quarter hour person. You know, maybe like a smidge more might be good. I mean, or some people are just that quick to fall asleep. There’s also variation there.

Clint Murphy  33:06

I kind of cheat when I say six and a half. That’s time in bed. Not Not. Not? More like yeah, so yes, my latency should apparently want to increase the latency. Yeah, read every time I checked the tracker. Oh, yeah. latency.

Jade Wu  33:22

Yeah. Should be about 15 ish, 20 ish minutes, like 10 to 20 minutes would be pretty typical for how long it takes to fall asleep?

Clint Murphy  33:29

Yeah, no, it’s been a while since that. That was back when I maybe a decade ago. years ago. I hear you. Okay, sorry, I distracted from where you were going. So

Jade Wu  33:42

those are the main ones. And yeah, so late sleep latency, as we mentioned, is how long you take to fall asleep. And then wake after sleep onset or way. So is how long you’re awake, you know, in the middle of the night. And that should be or, I mean, there’s more variability there that could be zero, that’s fine. But it can be 30. And that’s also fine. And maybe 45. That’s, that could be okay, too. So it kind of that one’s a little bit more flexible. And also, that was the trickiest to track in a way because oftentimes, we’re waking up and not realizing it. In fact, one of the biggest differences between someone with insomnia and someone without is that someone that is that they might wake up the exact same number of times and awake for the same amount of time during the night. But the person with insomnia will remember it, whereas the person without insomnia would not remember it. And that’s part of what contributes to the frustration of insomnia is that you remember every time you woke up and it just feels like such a drag. Whereas in reality, that amount of waking up is actually normal and healthy and fine. But if your brain is sort of on the lookout for those wake ups, and you notice and remember all of those wake ups and you’re interpret those wake ups as bad sleep, or like interruptions to your sleep, that it feels worse and you have more insomnia So

Clint Murphy  35:00

tying to that with sleep Jade is one of the problems you say we have the one of the big drivers is this idea of arousal. And so we’re just kind of getting our energy up and you talk about three different ways that we can have that energy and one of them is conditioned arousal. Can you take our audience through? What are these different ways we get our energy up? And why is one of the simplest things we can do for conditioned arousal and to help with our sleep? Being? The only thing we should do in our bed? is sleep. Yep.

Jade Wu  35:39

Great question. So first of all, I would make a slight tweak to say that it’s not so much we’re getting our energy up, because it’s not necessarily real energy, right? It’s not like you suddenly gained nutrition or, you know, whatever, in that moment. So it’s not real energy is really more like getting more wired or jazzed up or frazzled, or you know, adrenaline up or stressed out. So I just like to call it wired. So there are a few ways that you can be too wired at night. So there’s, you know, the obvious ones, like if you drink a pot of coffee, with dinner, then yeah, you’ll probably be too wired by bedtime. If you are worried or stressed, you might be sitting there with thoughts spinning about, you know, worst case scenarios, that’s one way to get wired. Conditioned arousal is an interesting one, because it’s kind of one of those that nobody thinks about, but it’s super powerful. So it really just means the brain is very good at putting two and two together. So if you always get popcorn, when you go to a movie theater, like every time you walk into a movie theater, your mouth is going to start watering. And you’re going to start craving that buttery popcorn, right, our brains are just really good at putting two and two together. So if you’re often awake and frustrated in bed, then your brain is learning that the bed is an awake and frustrating place. So that’s another way that’s a vicious cycle where the more you have insomnia, the more time you spend awake in bed being frustrated and anxious, the more you’ve gotten conditioned arousal, and the next time you go to bed, your brain is going to say, Oh, I know what this place is. This is where we get all frazzled, annoyed and frustrated. So it’s kind of a self fulfilling prophecy again. So the last thing we should do in bed is to be awake and frustrated. So, you know, traditionally the rule is don’t do anything but sleep in bed. And yeah, I think that’s a good rule of thumb to go by, I tend to be a little bit more lenient about that. Like, if people want to just hang out with their dog or their partner in bed, that’s okay. If they want to read in bed, that’s okay. Like, if they want to meditate in bed, that’s okay. Like, if you’re hanging out and relax and happy, as long as not all day long, like for many hours, yeah, go ahead and spend time in bed. But don’t like do your taxes in bed, don’t have arguments in bed. You know, don’t do things that are strenuous, or annoying, or, you know, effortful in bed, and don’t like play Grand Theft Auto and bed, you know, those kinds of things. And then the very worst thing you can do in bed is try really hard to sleep. While you’re not sleeping. That’s the very last thing you should do is

Clint Murphy  38:26

that going back to that condition is that because you’re training yourself that sleep has to be a fight. And every time I come into this bed, like I’m going to get into a sleep fight. Exactly.

Jade Wu  38:37

A lot of patients of mine actually describe it as like, all right gearing for battle, they’re like putting on their pajamas and just going like, okay, are getting ready for this battle. That happens every night. It’s like, oh my gosh, that’s so sad that sleep, you know, could be such a good friend and you’re preparing for battle with every night, you know, it really should be a lot more of a happy and like, you know, when you go to bed, it should feel like ah, you know, I’m so happy to be here. I’m relaxed, and you know, looking forward to it. That’s how it should. Okay,

Clint Murphy  39:11

so let’s talk about the idea of circadian dysregulation, you know, just jumping right into that very scientifically term. What is it? And how can we work with light throughout different times of the day, and waking up consistently? How do those two things help us regulate our circadian?

Jade Wu  39:34

Yeah, so the circadian system is a network of clocks in your body. So you have billions of these, like most of your cells have their own little clock and your organ systems have clocks. Your metabolism has a clock, you know, your brain has lots of clocks. And then there’s a master clock in the brain, that sort of the clock to rule them all. And this is called the Super Supra charismatic nucleus. We’ll just call it the master clock because Is the other term is way too hard to say. So the master clock kind of orchestrates, you know, when you release your hormones, when you feel sleepy versus awake, when your metabolism functions, you know, gears up versus ramps down. And when your thoughts are more clear and active versus, you know, relaxed. So all of these things run on clocks, and the master clock is overseeing all the operations. And your master clock can do its job best when it knows what time it is. And it cannot tell what time it is just on its own. Because your brain is a dark, dark cave, and your brain inside does not know what time it is, except through the window of your eyes. So the amount of light that comes in through your eyes directly signals the brain, specifically the master clock, to tell it Oh, it’s daytime, or Oh, no, it’s bedtime, or oh, it’s nighttime. So you know, as humans evolved, we really only had bright, you know, broad spectrum light during the day, and we only had maybe fire light at night. So like orangey, you know, amber color lights. So our brains don’t work that way, when we have blue light, broad spectrum light, then our brain thinks it’s daytime, when we have low dim lights, or no lights, or just orangey lights than our brains think it’s nighttime. So to make our masterclass very happy, we want to be extremely clear about what time it is day versus night. And we want to be very predictable about the timing of that. So what that means is getting up and going to bed about pretty much the same time every night. And also getting lots of light during the day, especially in the mornings, and not getting a lot of late at night. So whether that’s dimming your screens, or just not being on screens very much wearing blue light blocking glasses, we want to make the contrast between day and night, crystal clear. And that way your master clock in your brain will be very happy. And when it’s happy, it’s able to make you sleepy, when you’re supposed to be sleepy make you awake when you’re supposed to be awake, and do all the functions of your body beautifully.

Clint Murphy  42:14

And so when you think about the hackers who want to their way to perfection, and everything is this one of the ones that’s a bit over done with you know, I’ve got to wake up and in my first 15 minutes, I have to be outside skipping, staring into the sunshine. And by this time, I have to shut off any screen ever anywhere. And you know, maybe get my red light therapy and then jump into bed and sleep in it perfectly pitch black room for the average person. Like where’s there some truth there? And where do we say, hey, just get outside in the sunshine during the day and dim your screens at night? Like put it on night mode? Yes,

Jade Wu  42:54

I very much aligned with the second thing that you said more, just because I’ve just seen way too much of that perfectionism backfire. You know, lots of my patients have said, I have perfect flawless sleep hygiene. And I do this at exactly the right times, and I never eat more than this amount for my bedtime snack. And you know, they have it down to such a science, that it’s putting a lot of pressure on themselves to sleep well. And what they’re neglecting is that, first of all, there are natural fluctuations in what your body needs. So you can never perfectly control or predict what’s going to happen. And also, I think they’re neglecting that, you know, just listening to your body and going with the flow. That’s also really important. Sometimes, I mean, not sometimes I think most of the time your body is very wise and can tell you what it actually needs. And maybe what it needs today is just to chill out. Or to spend a little time with friends or like go for a walk, that is totally not goal oriented, you’re not counting how many steps you’re just enjoying the bird singing on the tree, you know, that’s sometimes what our bodies really need. So there’s a good balance to be struck, because for a lot of people, they do need a little bit more discipline or a little bit more consistency in their schedule to help their master clock really be on, you know, have a good predictable rhythm. That’s, you know, really important, but we really don’t need to make a perfect

Clint Murphy  44:26

in so everybody today probably hears this term sleep hygiene. And as we talk through it, we’ve talked some of the ideas but for you, we’ve got misconceptions, myths, and then we’ve got some absolutes out there. What are two or three things other than what we’ve already talked about, that you think most of the audience should be doing when it comes to sleep. And then after that, can we dive into some of the myths that are just a little overdone?

Jade Wu  44:53

Yeah, that’s a great question. Let’s see. Some absolutes. I mean, I think we’ve covered The good ones like the get lots of light during the day, if you can, you know, that’s a really good one. I guess we haven’t talked about caffeine very much yet. So caffeine, nothing’s of perfect absolute because some people will metabolize, metabolize caffeine quickly and well and just fine. And they can have a couple cups of cups of coffee and be okay. For other people, even a little bit of coffee can, you know, really wire them up, and they can be very sensitive to it. And also that changes too. So as we get older, we tend to become more sensitive to caffeine. And when someone’s pregnant, they are a whole lot more sensitive to caffeine, and they metabolize caffeine many times slower. So it kind of depends on our stage of life. But as a general rule of thumb, probably most people could stand to decrease their caffeine intake. Because caffeine is fake fuel, it does not actually give you energy, because it’s not nutrition, it’s not asleep, it’s not anything that really rejuvenates or recharges your body, it just kind of makes your body push through the tiredness, or the lack of sleep that it’s experiencing. So your body may be desperately trying to tell you something by being tired by being really groggy. But you’re basically ignoring that message by just bulldozing over that with caffeine and saying, Well, I can function as long as I have my coffee. But what’s really happening is you’re just repeatedly ignoring important signals from your body, and making your body function energy that it doesn’t have. And your body is just taking hits day after day after day. And at one point, you can’t really make up for that anymore. I mean, what the damage that’s done is done. So I think we all ought to be a little bit more compassionate with our bodies and listen to what it actually needs, whether it’s sleep or hydration with water, or you know, the other types of rejuvenation and recharge and rest that we’ve talked about. Because I think caffeine can become a crutch and not be very helpful in long run. And

Clint Murphy  47:10

when it comes to misconceptions, or even myths, what are two, or the three that really jumped out at you that, hey, maybe this isn’t as important as everyone keeps telling me. Yeah. So

Jade Wu  47:22

when it comes to sleep hygiene, let’s see. Okay, here’s one, we’ve talked about screens a little bit in the evenings. And I did mention, you know, we want to dim our screens. But some people are thinking, I need to not have screens at all, like I should not be having any light coming into my eyes after sunset or after a certain time. Or just, you know, like, social media is bad for sleep. And I think that can be true, but maybe not for the reasons that we think. So everybody’s worried about blue light. But like I said earlier, as long as you have lots of bright light during the day, then you have that contrast between day and night, then you’re all good. In fact, we know from research, if you have a good 30 ish minutes of broad spectrum, daylight exposure, basically going outside for 30 minutes, then you can use your screens at night for like a normal amount of time and be okay. But I think it’s the content and the intention behind the screen use that may really impact our sleep, which is you know, If we are using social media or watching TV or doing things in order to avoid giving our bodies and minds what they actually need, then again, we’re kicking the can down the line.You know, if we’re feeling stressed out or overwhelmed, or feeling like our, you know, emotional spiritual needs are not being fulfilled. And we try to avoid feeling bad about all those things by vegging out in front of this TV, that may work temporarily, you might get distracted by the Real Housewives of wherever, but then when you go to bed, it catches up with you, you know, all the worries that you didn’t address earlier are going to come flooding in, all the insecurities that you didn’t work on, might come in, you know, so then that really, you’re just borrowing time from yourself from the future and that future happens to be time that you should be sleeping. So that’s why I think, you know, you can totally use your screens at night and enjoy media, I love watching TV and doing all those things. But make sure you also save time to like process your feelings and thoughts to connect with your loved ones to really connect with your body and journal and you know, do the things that really fulfill you. And then when you go to bed, your mind is like satisfied. It doesn’t need to you know wrangle those other problems anymore, and it can relax and sleep. I love

Clint Murphy  49:54

1. We’ll switch directions for a moment. I’ll fire some rapid fire questions. That’s all right. Sure. What’s one of the most influential books in your life for you?

Jade Wu  50:04

Are we talking fiction or nonfiction?

Clint Murphy  50:06

Either or either or?

Jade Wu  50:08

Oh my gosh, ah, so hard to pick the Tigers wife by Taya Albrecht. Oh, what? Okay, one of my favorite books of all time is just so beautiful and haunting. And there’s like a dreamlike melodic quality to it. I you know, it almost makes you feel like you’re in that twilight zone between sleep and wake. And that’s, you know, a very interesting feeling to get from reading a book.

Clint Murphy  50:33

It’s called the Tigers wife. Okay, okay, I hadn’t heard that one before. I like it. So what’s on the shelf right now that you’re enjoying?

Jade Wu  50:41

I’m reading. This is so nerdy, but I’m actually reading a math book is called Oops. Okay, it’s about it’s literally just like, how do you prove things about numbers? And I enjoy it because it allows me to use my brain for just purely impractical. Like, it’s not good for any practical reason in my life. Just, it’s just for fun. It’s just intellectualizing for the fun of it, so that it scratches that itch.

Clint Murphy  51:13

What’s one thing that you’ve spent less than $1,000 on in the last year that Jade has thought to herself? I wish I’d bought this sooner?

Jade Wu  51:21

Oh, that’s such a good question. Ah, this is this is so like, trashy, but like supermarket sushi. It turns out, it’s like really satisfying. And like, you can just go in the middle of the day when you have like 30 minutes to spare and just get some like shitty sushi. And it’s like, the enjoyment to price ratio is just like, really high. And you can buy so much supermarket sushi with $1,000.

Clint Murphy  51:53

Yes, yeah, that would almost be disturbing. We have where I live here, we have a lot of sushi. So that would be scary. This shows about gross. So what’s one behavior change mindset shift, or new habit that you’ve introduced at some point in your life that had the most oversized impact for you.

Jade Wu  52:15

This one is recent. So I’m a mother of a four year old and two year old. And to be perfectly honest, I’ve had a kind of a hard time adjusting to motherhood, I mean, I love it, I adore my children. And it’s, I would not trade it for a different life. And it’s been really, really difficult to sort of lose my whole identity from previous to that and not be able to do a lot of the things that I used to do. So like I started having thoughts about Do I regret having children was this like, not the good the right choice for me. And that was like a really dark and disruptive thought for me. And so what I’ve started is to think about my thoughts as passengers on a bus. So this harkens back to our mindfulness discussion, it’s like, I’m driving this bus, and I have my route, and I have my destination, and I’m driving my bus, that’s my life. And sometimes there are passengers that are gonna get on the bus that I don’t like very much that are not very helpful, that are maybe even really rude or mean. And I can either argue with them or try to shove them off the bus or like, you know, take the bus off Route to accommodate them. Or I can just accept that sometimes this is going to happen, and I don’t have to take them seriously. I don’t have to, like, win any fights with them, I just let them do their thing in the back and whatever. And then I just keep driving. And I enjoy the passengers that I do like, and meanwhile I’ve not gone off Route. And I’ve, you know, I’m still doing my thing. So that’s been a really, really helpful framework for dealing with thoughts that I know are not helpful to me. And who knows if they’re true or not. But it doesn’t matter if they’re true, because reality is reality. So this has been a nice framework for me. And eventually they’ll get off the bus. Eventually they always do. Yeah.

Clint Murphy  54:00

Wow. I love that. I love that analogy. So if we look at the book, we went pretty deep, pretty wide. Is there anything we missed that you want to make sure the audience gets,

Jade Wu  54:12

I think let’s go full circle and say, your relationship with sleep is the most important thing. Because in a good relationship, you can weather changes, you can weather setbacks, and you have trust, that things will always get back on track no matter what. And you appreciate, you know the other person and just like you want to appreciate sleep. And if you have that foundation have a good relationship, you know, as change things change with your lifestyle or health or age or whatever. That’s okay. You can always adjust. So instead of chasing specific goals or metrics, let’s just chase a good relationship with sleep and you’ll be better served in the long term.

Clint Murphy  54:51

It’s wonderful. And where can people find you?

Jade Wu  54:53

Well, best place is my website. I’m not on social media very much these days, especially after you know Twitter. Turn into x. But I do give some pregnancy sleep advice and general sleep advice on Instagram. I met Dr. Jay will Dr. Underscore Jade underscore Woo and my website is Dr. Jade woo.com.

Clint Murphy  55:13

Love it. Thank you for joining me today. Thank

Jade Wu  55:16

you so much for having me. This was really fun